Sage, Black Cohosh, Saffron… Which plants are effective for a serene menopause?

Hormonal changes in the premenopause

The menopause corresponds to the permanent cessation of ovarian function, generally around the age of 51 [1]. It is accompanied by a significant drop in oestrogen, hormones that are essential to the balance of the female body.

Before this, a phase called perimenopause or premenopause can last up to 7 to 14 years [2], with significant hormonal fluctuations. This period is often the most difficult, as symptoms appear gradually. A woman can therefore be in perimenopause as early as 35–40 years of age. 

The most common symptoms and their impact

They are numerous and can significantly affect daily life. According to one study, the most common are [3]: 

• Hot flushes in 78% of cases and up to 85% [4] 
• Persistent increased sweating (84%)
• Sleep disturbances (67%)
• Increased irritability (79%)
• Low mood (64%) or even depression [5]
• Brain fog [6]
• Joint pain (69%)
• Palpitations (65%)
• Weight gain, raised cholesterol, etc. [7]
• Genitourinary problems [8]
• Osteoporosis [9]

Other manifestations are also found, such as hair loss, headaches, increased facial or body hair growth (hirsutism), palpitations, increased urinary frequency, changes in breast size or shape, as well as irritability, fatigue and memory disturbances such as frequent forgetfulness. It can also lead to unpredictable mood swings, anxiety, a decrease in sexual desire (libido), pain during sexual intercourse (dyspareunia), breast tenderness or pain, as well as vulvovaginal atrophy which can cause vaginal dryness.

These manifestations are not trivial: they can last several years and impact daily, professional and emotional life. Every woman is different and may experience just one or several of these signs. 

L'Organisation mondiale de la santé (OMS) considère la médecine complémentaire comme une méthode de prévention et d'amélioration des symptômes de la ménopause [10].

Dans ce contexte, un complément alimentaire ménopause à base de phytothérapie apparaît comme une approche naturelle pertinente, notamment pour les femmes qui ne souhaitent pas ou ne peuvent pas recourir à des traitements hormonaux.

Le traitement hormonal substitutif (THS) est une solution efficace afin de soulager rapidement les manifestations cliniques. Il agit sur les affections dites « climatériques », notamment liées aux changements des hormones associés à l’arrêt de la fonction ovarienne, comme les bouffées de chaleur, les sueurs, la sécheresse vaginale ou encore les perturbations de l’humeur. Il contribue également à la prévention de l’ostéoporose, en réduisant le risque de fractures osseuses de 30 à 40 %.

Toutes tranches d’âge confondues, le traitement hormonal n’est pas associé à une augmentation de la mortalité globale chez les femmes, ni à celle liée aux maladies cardiovasculaires ou au cancer du sein. Lorsqu’il est instauré dans les 10 premières années suivant la fin des règles, il pourrait même avoir un effet protecteur sur la mortalité [11].

La décision de mettre en route un traitement hormonal est individualisée à chaque femme. Son usage est encadré par avis d’un médecin, car il peut être associé à certains risques, notamment cardiovasculaires, thromboemboliques ou liés aux cancers hormonodépendants. C’est pourquoi il n’est pas systématiquement recommandé à toutes les femmes, et la prescription de médicaments nécessite une évaluation médicale personnalisée par un médecin ou gynécologue.

Dans ce contexte, les solutions naturelles comme les plantes médicinales représentent une alternative intéressante : elles permettent d’agir plus en douceur, tout en limitant les effets secondaires, à condition de choisir des actifs efficaces et sûrs.

Scientific research now makes it possible to clearly identify which plants are genuinely effective during this transition. Some stand out for their robust and reproducible clinical results. It is important to note that these are not medicines. 

Sage: proven efficacy on hot flushes

It is one of the best-documented plants. Several clinical trials show a significant effect from the first few weeks.

One study observed a reduction of 50% at 4 weeks and up to 64% at 8 weeks [12].

 

Another analysis shows that it leads to a significant and overall improvement in the following areas after 10 to 12 weeks of supplementation [13]: 

• Hot flushes and night sweats: up to −75%
• Sleep disturbances: improvement of −64%
• Muscle and joint pain: reduction of −52%
• Depressive mood: reduction of −50%
• Irritability: reduction of −49%
• Anxiety: reduction of −47%
• Cardiac discomfort (palpitations): reduction of −49%
• Urinary incontinence: improvement of −38%
• Sexual problems: improvement of −19%

Its mechanism is based in particular on modulation of neurotransmitters such as serotonin, which contributes to regulating the disrupted thermoregulation during this hormonal transition [14].

Shatavari: a comprehensive action on hormonal balance

Shatavari stands out for its comprehensive action on physical complaints, emotional wellbeing and hormonal imbalance.

In 60 days, shatavari helped to significantly improve the following areas [15]:

• -93% of hot flushes
• -92% of night sweats
• -41% on the overall insomnia score
• +35% overall quality of life
• -55% anxiety
• -53% stress
• +43% sleep quality

This efficacy is explained by its richness in natural phytoestrogens, which help to gently compensate for the decline in oestrogen levels.

Saffron: a demonstrated impact on mood and sleep

Saffron is particularly interesting for the emotional difficulties associated with the menopause, but not only that!

Its efficacy has been demonstrated in particular on [16]:

• -50% impact of hot flushes compared to baseline, and 60 to 65% additional reduction versus placebo on associated discomfort
• 50% improvement in depressive indicators from 2 weeks, and 73% improvement at 4 weeks
• 40 to 60% additional benefit versus placebo for depression associated with the menopause

It acts on neurotransmitters (particularly serotonin), making it a valuable ally for stabilising mood.

Milk thistle: essential metabolic support

Less well known in the context of the menopause, milk thistle nonetheless plays a key role.

Its active compound, silymarin, has the following properties:

• Powerful antioxidant properties [17]
• Hepatoprotective [18]
• Beneficial for blood sugar levels [19]

As the liver is involved in hormonal regulation, its proper functioning is essential for navigating this period more comfortably.

Evening primrose oil: a useful support

Evening primrose oil has shown interesting results in menopausal women.

In a first study, an increase in oestradiol, a reduction in total cholesterol and an overall improvement were observed [20].

In a second study, evening primrose oil reduced hot flushes by 73%, sleep disturbances by 51% and musculoskeletal symptoms by 76%. The overall physical score also improved by 57% [21].

As it comes in oil form, it is less commonly found in supplements containing multiple active ingredients. 

Ashwagandha: be aware of contraindications

Ashwagandha has shown interesting results in women in perimenopause and menopause.

In a first study, it reduced the overall MRS score (menopause rating scale) by 23.5%, improved psychological domain scores by 25% and urogenital scores by 27%, whilst significantly reducing hot flushes. It was also associated with an increase in oestradiol and a reduction in FSH and LH [22].

In a second study [23], it reduced the overall MRS score by 40.9%, improved psychological symptoms by 44.6%, somatic symptoms by 42.1% and urogenital symptoms by 31.5%. Hot flushes decreased by 26.9%, with an increase in oestradiol and progesterone, a reduction in FSH and LH, as well as an improvement in quality of life and a 47% reduction in perceived stress.

In addition to its benefits on commonly experienced clinical symptoms, ashwagandha is also particularly useful for helping to reduce cortisol levels and better manage stress.

Although effective, this plant is not recommended in cases of:

• Endocrine disorders (thyroid, hyperandrogenism)
• Liver or heart conditions
• Treatments affecting the nervous system

Black cohosh: caution required

It is often used as it may be effective [24], particularly for hot flushes, but its use requires caution:

• Not recommended in cases of hormone-dependent cancer
• Hepatic risk

Soy: controversial phytoestrogens

Isoflavones may be useful and are well documented [25], but they should also be used with caution:

• Not recommended in cases of a history of breast cancer

It is an extract best chosen organic. 

Herbal teas, capsules or standardised extracts

Not all forms of plants offer the same effectiveness. Standardised extracts and capsules are the most recommended, as they provide a precise, concentrated dose of active ingredients, in line with what is used in scientific studies.

Herbal teas and infusions, on the other hand, are generally less concentrated. They can be pleasant to enjoy daily, but their effectiveness tends to be milder and less consistent.

Dosages and duration of use

Plants act gradually. The first effects are often felt after 2 to 4 weeks, with more noticeable results after 1 to 3 months of regular use.

The key is consistency and a sufficient dosage in order to achieve visible results.

Even though plants are natural compounds, they are not always risk-free. It is essential to understand the precautions to take before any use.

Drug interactions

Some plants may interact with medications, which can alter their efficacy or cause unwanted side effects: 

• Antidepressants: some that act on serotonin (such as saffron or ashwagandha) may potentiate their effect.
• Anticoagulants: some may influence blood clotting.
• Hormonal treatments: those containing phytoestrogens may interact.

It is therefore recommended to seek the advice of a healthcare professional (doctor, gynaecologist) if you are currently undergoing any treatment.

At-risk profiles

Certain situations require particular vigilance:

• Personal or family history of hormone-dependent cancers
• Thyroid or endocrine system dysfunction
• Hepatic or cardiac conditions

These limitations explain why certain formulations favour actives without major contraindications, in order to ensure greater safety of use.

Toutes les plantes n’agissent pas de la même manière, et c’est justement là que réside l’intérêt des formulations combinées. Pendant la ménopause, les symptômes sont multiples et interconnectés : bouffées de chaleur, difficultés pour dormir, fatigue, variations d’humeur, déséquilibres métaboliques… Une seule plante ne peut pas couvrir l’ensemble de ces besoins.

C’est pourquoi certaines associations d’actifs sont particulièrement pertinentes. Par exemple, la sauge agit principalement sur les indicateurs vasomoteurs comme les bouffées de chaleur, tandis que le shatavari intervient davantage sur la régulation hormonale globale. Le safran, lui, cible la sphère émotionnelle et la relaxation, alors que le chardon-marie soutient le foie et le métabolisme.

Cette complémentarité permet une approche beaucoup plus globale et efficace. Au lieu de traiter un seul symptôme, on agit sur plusieurs mécanismes en même temps, ce qui améliore significativement le quotidien.

De plus, certaines formulations ont été pensées afin d’éviter les actifs présentant des contre-indications. Cela permet d’obtenir un produit à la fois efficace et adapté au plus grand nombre de femmes, y compris celles ayant des profils sensibles.

Dans cette logique, Péri Support a été formulé afin d’offrir une réponse végétale, ciblée et complémentaire aux différents inconforts de la périménopause. Son association de sauge, shatavari, safran et chardon-marie permet d’agir à la fois sur le confort vasomoteur, le bien-être féminin, l’humeur et le soutien métabolique. Sans hormones et 100 % végétal, il peut s’intégrer facilement dans une routine globale et être associé à notre complément alimentaire préménopause multivitamines Péri Essentials, qui accompagne les besoins nutritionnels, la vitalité et les fonctions cognitives grâce notamment à son extrait breveté de bacopa.

If you are wondering which plant to use for the menopause, the most relevant answer is grounded in science and safety.

The most effective are:

• Sage: hot flushes
• Shatavari: hormonal balance
• Saffron: mood
• Milk thistle: metabolism and liver health

Some popular plants carry risks, which makes formulations with no particular contraindications especially valuable.

The ideal approach remains a holistic, natural and scientifically validated one, combining efficacy and safety. It is also important not to overlook the impact of a healthy diet and regular physical activity. It has been shown that exercise also helps to reduce clinical signs.